Decrease and Smooth Variation:
Dedicate Operating Room(s) for Unscheduled Surgeries
When unscheduled (emergent, urgent, etc.) surgical demand is significant, it creates a major obstacle in smoothing elective admissions since such demand cannot be controlled. Scheduled and unscheduled surgical demands compete for the same operating room (OR) resources. An attempt to increase OR utilization rate will result in diminishing quality of care by increasing patient waiting times for unscheduled surgeries. An attempt to reduce waiting times for unscheduled surgeries will inevitably reduce OR utilization rate. Therefore, according to the variability methodology, when demand for unscheduled surgeries is significant, these surgeries should take place in operating room(s) designated for this purpose.
- Collect accurate data on demand for scheduled and unscheduled surgery.
- Collect accurate data on the volume and arrival patterns of patients representing different components of unscheduled surgical demand: emergent, urgent, semi-urgent, and non-urgent surgeries.
- Determine the average waiting times that would be tolerated for each type of unscheduled surgical demand (e.g., average waiting time for emergent surgeries should not exceed 20 minutes).
- Apply queuing theory to determine the number of ORs needed for unscheduled demand, based on the average waiting times for different levels of urgency (emergent, urgent, etc.).
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Use information about scheduled case demand, duration, turnover times, and the prime time to estimate the number of ORs needed for scheduled surgeries.
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